Screening for gestational diabetes early helps ensure a healthy future for mother and child.

• The World Health Organization (WHO) chose the theme ‘Healthy Beginnings, Hopeful Futures’ to highlight the theory of primordial prevention, or preventing diabetes in the womb itself.

• Gestational diabetes mellitus (GDM) increases the risk of type 2 diabetes in mothers and metabolic disorders in children.

• GDM is usually diagnosed between 24 and 28 weeks of pregnancy, but evidence suggests it could be onset during the first trimester or earlier.

• Maternal glucose levels should be carefully regulated as early as the eighth week of pregnancy to prevent foetal hyperinsulinemia, a metabolic disturbance that occurs in the 11th week.

• The ‘Foetal Origin of Adult Diseases’ (Barker’s Hypothesis) suggests that conditions during gestation will affect the child’s health over the long term.

• A new model of early GDM intervention has been proposed, focusing on a key eight-point agenda: glucose testing by eight weeks of pregnancy, preventing foetal hyperinsulinemia, and halting the rise of glucose to prevent the development of GDM later in pregnancy.

• In India, about 20% of pregnant women in India develop GDM, exposing both the mothers and their offspring to long-term health burdens related to metabolic disease.

• The majority of women of Indian origin do not go for antenatal checkups until the second trimester, thereby missing the screening period.

• The development of early GDM screening and intervention policy across the country is now absolutely critical.

• Diabetologists have recently urged early detection of blood glucose levels, risk modification through pre-conception period concerns, dietary control, exercise, and preventive medication before conception.

• To ensure this new approach works, there is a need for a new conceptualisation of maternal care involving all stakeholders, including the care providers, policymakers, and the general public.